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MAIDA TAYLOR, MD, MPH, FACOG Assistant
Clinical Professor University of California San Francisco
Department of Reproductive Sciences, Obstetrics and Gynecology
San Francisco, California
COMPLIMENTARY THERAPIES 1997, 23(8):514-532
Alternative medicines have become "mainstream"
in their popularity and economic size. The most highly promoted
and popular types of alternative medicines used for menopause
are discussed, including mineral and vitamin supplements,
phytoestrogens, natural hormones, and botanical/plant medicines.
More than 8 million women in the United
States will turn 50 this year. As cohorts who were born between
1947 and 1957 turn age 50 in the next decade, the medical
world will encounter the largest number of menopausal women
ever.
The treatment of the perimenopausal transition,
menopausal symptoms and complications of estrogen deficiency
has begun an inexorable and dramatic ascent. Although health
professionals strongly advocate the use of estrogen replacement,
fewer than one in four candidates actually take postmenopausal
estrogens.
The print media, radio, television, bookstores,
health food stores, and the Internet are replete with ads
and promotions for alternatives to hormones, and women are
buying these alternatives, as are Americans in general.
Physicians, nurses, and other practitioners
must understand the forces that drive patients away from the
conventional path and onto the roads less traveled. In fact,
alternative medicine is no longer a poor relation of conventional
medicine. Alternatives have become mainstream in their popularity
and economic size.
Before assessing whether alternative therapies
offer significant benefits and whether they can, substitute
for current therapies, conventional hormone therapy must be
subjected to some degree of scrutiny. If alternatives and
complementary therapies are to be held to a high standard
of epidemiologic proof and evidenced-based medicine, the same
standards must be applied to conventional drug therapies.
Moreover, a critical review of conventional hormone replacement
therapy (HRT) may help explain, why women seem so reluctant
to take hormones, despite the apparently overwhelmingly positive
impact they have on osteoporotic and cardiovascular risk.
After weighing the evidence about HRT, this
article looks at the most highly promoted and, popular types
of alternative medicines used for menopause, including mineral
and vitamin supplements, phytoestrogens, natural hormones,
and botanical/plant medicines. It is not practical to cover
all the alternative health systems and practices used during
menopause, since such practices vary from region to region,
depending on the local religions, cultural, and immigrant
populations.
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